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Diagnostics
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Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders
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Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 8689

Special Issue Editors

Dr. Francesco Fiz

E-Mail Website
Guest Editor
Nuclear Medicine Unit, E.O. Ospedali Galliera, Genoa, Italy
Interests: nuclear medicine; radioisotope therapy; PET/CT; hematology; plaque imaging; image segmentation; texture analysis; radiomics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Luca Viganò

E-Mail Website
Guest Editor
Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
Interests: abdominal surgery; with specific interest in hepato-biliary surgery; with both traditional and minimally invasive approaches; intraoperative ultrasound

Special Issue Information

Dear Colleagues,

Gastrointestinal and hepato-bilio-pancreatic disorders, including benign and malignant oncological diseases, acute and chronic intestinal ailments, and exotoxin-related syndromes, can present a relevant diagnostic challenge. Issues in radiological diagnosis stem from complex anatomy of the abdominal region and difficult differential diagnosis among diseases at different prognoses and treatments but with a similar presentation at standard imaging modalities. In recent years, precision medicine approaches have gained traction but require accurate diagnostic pipelines. Tumor details, such as relationship with surrounding organs (namely the vessels), micrometastases, and residual disease after systemic therapy are crucial to planning an adequate treatment. Significant progress in imaging methods, such as imaging fusion, advanced segmentation, texture analysis, and artificial intelligence, have been recently reported and are the object of major research to extract as much information as possible from the available imaging data.

In this issue, we aim to gather the latest available evidence on any advanced and innovative imaging approach, aiming at diagnosis, staging or treatment guidance of gastrointestinal and hepato-bilio-pancreatic disorders. Manuscripts describing any types of imaging, i.e., US, CT, MRI, scintigraphy or PET can be submitted to this Special Issue.

We look forward to receiving your contributions.

Dr. Francesco Fiz
Prof. Dr. Luca Viganò
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal and hepato-bilio-pancreatic disorders
  • benign and malignant oncological diseases
  • acute and chronic intestinal ailments
  • exotoxin-related syndromes
  • radiological diagnosis
  • abdominal region
  • precision medicine
  • imaging fusion
  • advanced segmentation
  • texture analysis
  • artificial intelligence
  • US, CT, MRI, scintigraphy or PET

Published Papers (6 papers)

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Research

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11 pages, 1541 KiB  
Article
Rim Enhancement on Contrast-Enhanced CT as a Predictor of Prognosis in Patients with Pancreatic Ductal Adenocarcinoma
by Takeru Yamaguchi, Keitaro Sofue, Eisuke Ueshima, Naoki Sugiyama, Shinji Yabe, Yoshiko Ueno, Atsuhiro Masuda, Hirochika Toyama, Takayuki Kodama, Masato Komatsu, Masatoshi Hori and Takamichi Murakami
Diagnostics 2024, 14(8), 782; https://doi.org/10.3390/diagnostics14080782 - 09 Apr 2024
Viewed by 350
Abstract
This study investigated the utility of imaging features, such as rim enhancement on contrast-enhanced CT (CECT), in predicting the prognosis of pancreatic ductal adenocarcinoma (PDAC). This retrospective study included 158 patients (84 men; mean age, 68 years) with pathologically confirmed PDAC. The following [...] Read more.
This study investigated the utility of imaging features, such as rim enhancement on contrast-enhanced CT (CECT), in predicting the prognosis of pancreatic ductal adenocarcinoma (PDAC). This retrospective study included 158 patients (84 men; mean age, 68 years) with pathologically confirmed PDAC. The following imaging features were evaluated on CECT by two radiologists: tumor size, tumor attenuation, and the presence of rim enhancement. Cox proportional hazards analysis was performed to identify the imaging and clinicopathological features for predicting disease-free survival (DFS) and overall survival (OS). Pathological features were compared with the presence of rim enhancement. Among the 158 patients, 106 (67%) underwent curative surgery (surgery group) and 52 (33%) received conservative treatment (non-surgery group). Rim enhancement was observed more frequently in the non-surgery group than in the surgery group (44% vs. 20%; p < 0.001). Rim enhancement showed significant associations with shorter DFS and OS in the surgery group (hazard ratios (HRs), 3.03 and 2.99; p < 0.001 and p = 0.003, respectively), whereas tumor size showed significant associations with shorter OS (HR per 1 mm increase, 1.08; p < 0.001). PDACs with rim enhancement showed significant associations with higher histological tumor grades (p < 0.001). PDAC with rim enhancement on CECT could predict poorer prognosis and more aggressive tumor grades. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)
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11 pages, 5945 KiB  
Article
Hyper Mucinous Proliferations in the Mucosa of Patients with Inflammatory Bowel Disease: Histological Lesions with a Real Potential for Neoplastic Evolution?
by Enrico Costantino Falco, Davide Giuseppe Ribaldone and Gabriella Canavese
Diagnostics 2024, 14(5), 499; https://doi.org/10.3390/diagnostics14050499 - 26 Feb 2024
Viewed by 616
Abstract
Background and Aims: Mucin disfunction is a critical event in the pathogenesis of inflammatory bowel disease (IBD). Although hyper mucinous conditions have a still debated implication in the clinical evolution of this disorder, hyper mucinous villous proliferations were found to have a preneoplastic [...] Read more.
Background and Aims: Mucin disfunction is a critical event in the pathogenesis of inflammatory bowel disease (IBD). Although hyper mucinous conditions have a still debated implication in the clinical evolution of this disorder, hyper mucinous villous proliferations were found to have a preneoplastic biologic potential. We studied morphologic and immunophenotypic characteristics of these lesions in ileocolonic resections for IBD to add evidence about the evolutive potential of these lesions in samples with well oriented wall structures. Methods: Morphologic characteristics of bowel samples from 20 patients resected for IBD and with raised lesions at gross examination were studied and sections from cases with hyper mucinous lesions were stained with the following antibodies: Ki 67, p21, and p27, which were employed to evaluate the characteristics of the proliferative and differentiative activity of the epithelial structures; mismatch repair proteins and p53 have been studied as proteins implicated in carcinogenesis in IBD-affected mucosa; mucins subtypes in hyper mucinous structures were evaluated with MUC-2 and MUC-6. The results in 11 cases of saplings were that they harbored hyper mucinous proliferations. The occurrence of hyper mucinous structures was not related to dysplastic lesions, pseudo pyloric metaplasia, subtype of disease, or activity. In only one of our cases, mild cytologic atypia in the proliferative compartment was detected. Proliferation markers (Ki 67, p53) were expressed in the proliferative compartments of mucosal crypts and antiproliferative proteins p21 and p27 were expressed in differentiated epithelium. MMR proteins expression was limited to the proliferative compartment of the hyper mucinous projections. Mucin subtypes distribution was regular in the epithelium of hyper mucinous proliferations. Conclusions: The present monocentric retrospective study was conducted on surgical samplings with well oriented crypts. Collected data show that hyper mucinous features are frequent occurrences in raised lesions in IBD patients. In hyper mucinous proliferations of the selected cases, the status of the proliferative cycle, the expression of the proteins most frequently involved in carcinogenetic pathways of mucosa affected by IBD, and the mucins subtypes expression have no evident anomalies. Findings are not consistent with the increased risk of neoplastic evolution observed in other studies; rather, they suggest a hyperplastic nature. However, the capacity of hyper mucinous raised lesions for neoplastic evolution should be ruled out with more extensive prospective studies to identify functional defects that could explain the hypothesized neoplastic potential. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)
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12 pages, 4432 KiB  
Article
Quantitative Edge Analysis of Pancreatic Margins in Patients with Chronic Pancreatitis: A Correlation with Exocrine Function
by Maria Chiara Ambrosetti, Annamaria Grecchi, Alberto Ambrosetti, Antonio Amodio, Giancarlo Mansueto, Stefania Montemezzi and Giulia A. Zamboni
Diagnostics 2023, 13(13), 2272; https://doi.org/10.3390/diagnostics13132272 - 05 Jul 2023
Cited by 1 | Viewed by 906
Abstract
Background: Many efforts have been made to improve accuracy and sensitivity in diagnosing chronic pancreatitis (CP), obtaining quantitative assessments related to functional data. Our purpose was to correlate a computer-assisted analysis of pancreatic morphology, focusing on glandular margins, with exocrine function—measured by fecal [...] Read more.
Background: Many efforts have been made to improve accuracy and sensitivity in diagnosing chronic pancreatitis (CP), obtaining quantitative assessments related to functional data. Our purpose was to correlate a computer-assisted analysis of pancreatic morphology, focusing on glandular margins, with exocrine function—measured by fecal elastase values—in chronic pancreatitis patients. Methods: We retrospectively reviewed chronic pancreatitis patients who underwent fecal elastase assessment and abdominal MRI in our institute within 1 year. We identified 123 patients divided into three groups based on the fecal elastase value: group A with fecal elastase > 200 μg/g; group B with fecal elastase between 100 and 200 μg/g; and group C with fecal elastase < 100 μg/g. Computer-assisted quantitative edge analysis of pancreatic margins was made on non-contrast-enhanced water-only Dixon T1-weighted images, obtaining the pancreatic margin score (PMS). PMS values were compared across groups using a Kruskal–Wallis test and the correlation between PMS and fecal elastase values was tested with the Spearman’s test. Results: A significant difference in PMS was observed between the three groups (p < 0.0001), with a significant correlation between PMS and elastase values (r = 0.6080). Conclusions: Quantitative edge analysis may stratify chronic pancreatitis patients according to the degree of exocrine insufficiency, potentially contributing to the morphological and functional staging of this pathology. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)
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13 pages, 1397 KiB  
Article
Developing a Simple Score for Diagnosis of Acute Cholecystitis at the Emergency Department
by Saowaluck Faikhongngoen, Boriboon Chenthanakij, Borwon Wittayachamnankul, Phichayut Phinyo and Wachira Wongtanasarasin
Diagnostics 2022, 12(9), 2246; https://doi.org/10.3390/diagnostics12092246 - 17 Sep 2022
Cited by 1 | Viewed by 2857
Abstract
We aim to develop a diagnostic score for acute cholecystitis that integrates symptoms, physical examinations, and laboratory data to help clinicians for timely detection and early treatment of this disease. We retrospectively collected data from our database from 2010 to 2020. Patients with [...] Read more.
We aim to develop a diagnostic score for acute cholecystitis that integrates symptoms, physical examinations, and laboratory data to help clinicians for timely detection and early treatment of this disease. We retrospectively collected data from our database from 2010 to 2020. Patients with acute abdominal pain who underwent an ultrasound or computed tomography (CT) scan at the emergency department (ED) were included. Cases were identified by pathological, CT, or ultrasound reports. Non-cases were those who did not fulfill any of these criteria. Multivariable regression analysis was conducted to identify predictors of acute cholecystitis. The model included 244 patients suspected of acute cholecystitis. Eighty-six patients (35.2%) were acute cholecystitis confirmed cases. Five final predictors remained within the reduced logistic model: age < 60, nausea and/or vomiting, right upper quadrant pain, positive Murphy’s sign, and AST ≥ two times upper limit of normal. A practical score diagnostic performance was AuROC 0.74 (95% CI, 0.67–0.81). Patients were categorized with a high probability of acute cholecystitis at score points of 9–12 with a positive likelihood ratio of 3.79 (95% CI, 1.68–8.94). ED Chole Score from these five predictors may aid in diagnosing acute cholecystitis at ED. Patients with an ED Chole Score >8 should be further investigated. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)
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Review

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16 pages, 307 KiB  
Review
Application of Ultrasound Elastography in Assessing Portal Hypertension
by Man Zhang, Hongyu Jin, Jiazhi Cao, Ruyu Ren, Menglu Jia, Yi Yang, Xinyi Li, Ming Chen, Shen Li, Libin Huang and Wenwu Ling
Diagnostics 2022, 12(10), 2373; https://doi.org/10.3390/diagnostics12102373 - 29 Sep 2022
Viewed by 1770
Abstract
Portal hypertension is a common manifestation in late-to-end-stage liver diseases and can cause severe complications such as ascites, hepatic encephalopathy, etc. However, an early diagnosis of portal hypertension is often difficult as it can be asymptomatic. Though the gold standard to diagnose portal [...] Read more.
Portal hypertension is a common manifestation in late-to-end-stage liver diseases and can cause severe complications such as ascites, hepatic encephalopathy, etc. However, an early diagnosis of portal hypertension is often difficult as it can be asymptomatic. Though the gold standard to diagnose portal hypertension is hepatic vein catheterization, ultrasound elastography is regarded as a noninvasive alternative that can be used to accurately predict portal hypertension and a few further complications such as gastro-esophageal varices. Since ultrasound elastography is available in most medical centers, and is cheaper and noninvasive, studying its function in predicting portal hypertension is of paramount importance. Therefore, this review generalized the results of recently published articles in order to establish the indicators that were related to diagnostic and prediction efficiency. Our study found that various technologies of ultrasound elastography could be used to predict portal hypertension with satisfactory diagnostic sensitivity, specificity, accuracy, and AUC. Meanwhile, we also recognized similar diagnostic efficiency of ultrasound elastography in gastro-esophageal varices. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)

Other

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14 pages, 523 KiB  
Systematic Review
Percutanous Electrochemotherapy (ECT) in Primary and Secondary Liver Malignancies: A Systematic Review
by Vincenza Granata, Roberta Fusco, Valeria D’Alessio, Igino Simonetti, Francesca Grassi, Lucrezia Silvestro, Raffaele Palaia, Andrea Belli, Renato Patrone, Mauro Piccirillo and Francesco Izzo
Diagnostics 2023, 13(2), 209; https://doi.org/10.3390/diagnostics13020209 - 05 Jan 2023
Cited by 7 | Viewed by 1409
Abstract
The aim of the study was to analyse papers describing the use of Electrochemotherapy (ECT) in local treatment of primary and secondary liver tumours located at different sites and with different histologies. Other Local Ablative Therapies (LAT) are also discussed. Analyses of these [...] Read more.
The aim of the study was to analyse papers describing the use of Electrochemotherapy (ECT) in local treatment of primary and secondary liver tumours located at different sites and with different histologies. Other Local Ablative Therapies (LAT) are also discussed. Analyses of these papers demonstrate that ECT use is safe and effective in lesions of large size, independently of the histology of the treated lesions. ECT performed better than other thermal ablation techniques in lesions > 6 cm in size and can be safely used to treat lesions distant, close, or adjacent to vital structures. ECT spares vessel and bile ducts, is repeatable, and can be performed between chemotherapeutic cycles. ECT can fill the gap in local ablative therapies due to being lesions too large or localized in highly challenging anatomical sites. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Gastrointestinal and Hepato-Bilio-Pancreatic Disorders)
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